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2003, Number 3

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Acta Med 2003; 1 (3)

Selective lymphadenectomy of the sentinel node in patients with breast cancer. An alternative to the axillary dissection

Gallegos HJF

Language: Spanish
References: 18
Page: 127-131
PDF size: 57.54 Kb.


ABSTRACT

Introduction: The standard surgical treatment of patients with breast cancer is primary tumor resection (segmentectomy or mastectomy) and axillary dissection with staging and prognosis purposes. Approximately 60% of patients without palpable nodes and tumors of ‹ 5 cm do not have axillary metastasis in the dissection specimen and surgical morbidity is 25%. Sentinel node selective lymphadenectomy (SNSL) offers staging without the need for axillary dissection and with less morbidity. We reported on the experience obtained with SNSL with two different techniques. Methods: A total of 91 patients with breast cancer at stages I–II without palpable nodes received SNSL treatment with two techniques: Group 1) 67 patients with dye technique, and Group 2) radiocolloid and dye technique in 24 patients. We calculated success index, false negative rate, and predictive values. All patients had axillary dissection. Results: Group 1 had a 86.5% success index, 18% false negative rate, and 80% negative predictive value, while group 2 had a 100% success index, no false negatives, and two (8%) patients with extra-axillary drainage. Conclusions: SNSL identifies patients who are candidates for lymphadenectomy, prevents unnecessary morbidity, and satisfactorily stages patients without hidden metastasis. Dye/radiocolloid technique decreases false negative rate, increases index of success, and identifies extra-axillary drainage.


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